1.Preparation and antibacterial properties of porcine small intestinal submucosal composite nanohydroxyapatite bioscaffold loaded with antimicrobial peptide KR-12-a5
Qiquan YAN ; Libin YANG ; Mengjun LI ; Yazhuo NI ; Keying CHEN ; Bo XU ; Yaoyang LI ; Shiqing MA ; Rui LI ; Jianwen LI
Chinese Journal of Tissue Engineering Research 2026;30(2):384-394
BACKGROUND:Bone tissue loss caused by tumors and trauma can have an adverse effect on postoperative rehabilitation.Therefore,scaffold materials are usually implanted during treatment.However,the existing implant materials are relatively simple and lack antibacterial properties.Early implantation may lead to iatrogenic autoinfection and have an adverse effect on osteogenesis.OBJECTIVE:To construct a KR-12-a5 polypeptide-nanohydroxyapatite-small intestinal submucosa composite scaffold and evaluate its feasibility as a material for promoting bone defect repair.METHODS:The small intestinal submucosa scaffold and the small intestinal submucosa scaffold containing 25,50,and 100 mg/mL nanohydroxyapatite(referred to as nHA-SIS scaffold)were prepared by 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride/N-hydroxysuccinimide cross-linking method.The appropriate scaffold was screened for subsequent experiments by mechanical property testing.The antibacterial properties of KR-12-a5 polypeptide solution against Staphylococcus aureus,Streptococcus gordonii,and Fusobacterium nucleatum were detected.The nHA-SIS scaffolds were immersed in 250,500,and 1 000 μg/mL KR-12-a5 peptide solutions for 24 hours,and then freeze-dried to obtain peptide-loaded nanohydroxyapatite-porcine small intestinal submucosa composite scaffolds(denoted as P-nHA-SIS scaffolds).The sustained-release properties of the three groups of scaffolds were characterized.The nHA-SIS scaffolds and the three groups of P-nHA-SIS scaffolds were co-cultured with Staphylococcus aureus,Streptococcus gordonii,and Fusobacterium nucleatum for 24 hours or 48 hours.The scaffolds with strong antibacterial ability were screened by live and dead bacteria staining and scanning electron microscopy for subsequent experiments.The degradation properties and water absorption rates of the uncross-linked small intestinal submucosa scaffolds,cross-linked small intestinal submucosa scaffolds,nHA-SIS scaffolds,and P-nHA-SIS scaffolds were characterized.The extracts of cross-linked small intestinal submucosal scaffolds,nHA-SIS scaffolds,and P-nHA-SIS scaffolds were co-cultured with MC3T3-E1 cells.CCK-8 assay and live-dead cell staining were performed.The effects of the extracts of the three scaffolds on the migration of MC3T3-E1 cells were detected by Transwell chamber assay.RESULTS AND CONCLUSION:(1)The elastic modulus and compressive strength of 25,50,and 100 mg/mL nHA-SIS scaffolds were higher than those of small intestinal submucosal scaffolds(P<0.05),among which the elastic modulus and compressive strength of 25 mg/mL nHA-SIS scaffolds were the highest,and this group of scaffolds were selected for subsequent experiments to load peptides.(2)KR-12-a5 peptide had strong antibacterial activity against common bacteria in bone defects(Staphylococcus aureus,Streptococcus gordonii,and Fusobacterium nucleatum).The three groups of P-nHA-SIS scaffolds all had sustained release properties.With the increase of peptide mass concentration,the antibacterial property of P-nHA-SIS scaffold was enhanced.Among them,the P-nHA-SIS scaffold loaded with 500 μg/mL peptide had achieved a satisfactory antibacterial effect,and this group of scaffolds would be selected in the future.(3)The degradation rate of the three groups of cross-linked scaffolds was lower than that of the uncross-linked scaffolds,and the water absorption rate was greater than that of the uncross-linked scaffolds.P-nHA-SIS scaffolds could promote the proliferation and migration of MC3T3-E1 cells without affecting the activity of MC3T3-E1 cells.(4)The results show that P-nHA-SIS scaffolds have strong antibacterial properties and the ability to promote the proliferation and migration of MC3T3-E1 cells,and are expected to be used in bone defect repair.
2.Preparation and antibacterial properties of porcine small intestinal submucosal composite nanohydroxyapatite bioscaffold loaded with antimicrobial peptide KR-12-a5
Qiquan YAN ; Libin YANG ; Mengjun LI ; Yazhuo NI ; Keying CHEN ; Bo XU ; Yaoyang LI ; Shiqing MA ; Rui LI ; Jianwen LI
Chinese Journal of Tissue Engineering Research 2026;30(2):384-394
BACKGROUND:Bone tissue loss caused by tumors and trauma can have an adverse effect on postoperative rehabilitation.Therefore,scaffold materials are usually implanted during treatment.However,the existing implant materials are relatively simple and lack antibacterial properties.Early implantation may lead to iatrogenic autoinfection and have an adverse effect on osteogenesis.OBJECTIVE:To construct a KR-12-a5 polypeptide-nanohydroxyapatite-small intestinal submucosa composite scaffold and evaluate its feasibility as a material for promoting bone defect repair.METHODS:The small intestinal submucosa scaffold and the small intestinal submucosa scaffold containing 25,50,and 100 mg/mL nanohydroxyapatite(referred to as nHA-SIS scaffold)were prepared by 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride/N-hydroxysuccinimide cross-linking method.The appropriate scaffold was screened for subsequent experiments by mechanical property testing.The antibacterial properties of KR-12-a5 polypeptide solution against Staphylococcus aureus,Streptococcus gordonii,and Fusobacterium nucleatum were detected.The nHA-SIS scaffolds were immersed in 250,500,and 1 000 μg/mL KR-12-a5 peptide solutions for 24 hours,and then freeze-dried to obtain peptide-loaded nanohydroxyapatite-porcine small intestinal submucosa composite scaffolds(denoted as P-nHA-SIS scaffolds).The sustained-release properties of the three groups of scaffolds were characterized.The nHA-SIS scaffolds and the three groups of P-nHA-SIS scaffolds were co-cultured with Staphylococcus aureus,Streptococcus gordonii,and Fusobacterium nucleatum for 24 hours or 48 hours.The scaffolds with strong antibacterial ability were screened by live and dead bacteria staining and scanning electron microscopy for subsequent experiments.The degradation properties and water absorption rates of the uncross-linked small intestinal submucosa scaffolds,cross-linked small intestinal submucosa scaffolds,nHA-SIS scaffolds,and P-nHA-SIS scaffolds were characterized.The extracts of cross-linked small intestinal submucosal scaffolds,nHA-SIS scaffolds,and P-nHA-SIS scaffolds were co-cultured with MC3T3-E1 cells.CCK-8 assay and live-dead cell staining were performed.The effects of the extracts of the three scaffolds on the migration of MC3T3-E1 cells were detected by Transwell chamber assay.RESULTS AND CONCLUSION:(1)The elastic modulus and compressive strength of 25,50,and 100 mg/mL nHA-SIS scaffolds were higher than those of small intestinal submucosal scaffolds(P<0.05),among which the elastic modulus and compressive strength of 25 mg/mL nHA-SIS scaffolds were the highest,and this group of scaffolds were selected for subsequent experiments to load peptides.(2)KR-12-a5 peptide had strong antibacterial activity against common bacteria in bone defects(Staphylococcus aureus,Streptococcus gordonii,and Fusobacterium nucleatum).The three groups of P-nHA-SIS scaffolds all had sustained release properties.With the increase of peptide mass concentration,the antibacterial property of P-nHA-SIS scaffold was enhanced.Among them,the P-nHA-SIS scaffold loaded with 500 μg/mL peptide had achieved a satisfactory antibacterial effect,and this group of scaffolds would be selected in the future.(3)The degradation rate of the three groups of cross-linked scaffolds was lower than that of the uncross-linked scaffolds,and the water absorption rate was greater than that of the uncross-linked scaffolds.P-nHA-SIS scaffolds could promote the proliferation and migration of MC3T3-E1 cells without affecting the activity of MC3T3-E1 cells.(4)The results show that P-nHA-SIS scaffolds have strong antibacterial properties and the ability to promote the proliferation and migration of MC3T3-E1 cells,and are expected to be used in bone defect repair.
3.Bacteroi des fragilis-derived succinic acid promotes the degradation of uric acid by inhibiting hepatic AMPD2: Insight into how plant-based berberine ameliorates hyperuricemia.
Libin PAN ; Ru FENG ; Jiachun HU ; Hang YU ; Qian TONG ; Xinyu YANG ; Jianye SONG ; Hui XU ; Mengliang YE ; Zhengwei ZHANG ; Jie FU ; Haojian ZHANG ; Jinyue LU ; Zhao ZHAI ; Jingyue WANG ; Yi ZHAO ; Hengtong ZUO ; Xiang HUI ; Jiandong JIANG ; Yan WANG
Acta Pharmaceutica Sinica B 2025;15(10):5244-5260
In recent decades, the prevalence of hyperuricemia and gout has increased dramatically due to lifestyle changes. The drugs currently recommended for hyperuricemia are associated with adverse reactions that limit their clinical use. In this study, we report that berberine (BBR) is an effective drug candidate for the treatment of hyperuricemia, with its mechanism potentially involving the modulation of gut microbiota and its metabolite, succinic acid. BBR has demonstrated good therapeutic effects in both acute and chronic animal models of hyperuricemia. In a clinical trial, oral administration of BBR for 6 months reduced blood uric acid levels in 22 participants by modulating the gut microbiota, which led to an increase in the abundance of Bacteroides and a decrease in Clostridium sensu stricto_1. Furthermore, Bacteroides fragilis was transplanted into ICR mice, and the results showed that Bacteroides fragilis exerted a therapeutic effect on uric acid similar to that of BBR. Notably, succinic acid, a metabolite of Bacteroides, significantly reduced uric acid levels. Subsequent cell and animal experiments revealed that the intestinal metabolite, succinic acid, regulated the upstream uric acid synthesis pathway in the liver by inhibiting adenosine monophosphate deaminase 2 (AMPD2), an enzyme responsible for converting adenosine monophosphate (AMP) to inosine monophosphate (IMP). This inhibition resulted in a decrease in IMP levels and an increase in phosphate levels. The reduction in IMP led to a decreased downstream production of hypoxanthine, xanthine, and uric acid. BBR also demonstrated excellent renoprotective effects, improving nephropathy associated with hyperuricemia. In summary, BBR has the potential to be an effective treatment for hyperuricemia through the gut-liver axis.
4.A quinolinyl analog of resveratrol improves neuronal damage after ischemic stroke by promoting Parkin-mediated mitophagy.
Qingqi MENG ; Yan MI ; Libin XU ; Yeshu LIU ; Dong LIANG ; Yongping WANG ; Yan WANG ; Yueyang LIU ; Guoliang CHEN ; Yue HOU
Chinese Journal of Natural Medicines (English Ed.) 2025;23(2):214-224
Ischemic stroke (IS) is a prevalent neurological disorder often resulting in significant disability or mortality. Resveratrol, extracted from Polygonum cuspidatum Sieb. et Zucc. (commonly known as Japanese knotweed), has been recognized for its potent neuroprotective properties. However, the neuroprotective efficacy of its derivative, (E)-4-(3,5-dimethoxystyryl) quinoline (RV02), against ischemic stroke remains inadequately explored. This study aimed to evaluate the protective effects of RV02 on neuronal ischemia-reperfusion injury both in vitro and in vivo. The research utilized an animal model of middle cerebral artery occlusion/reperfusion and SH-SY5Y cells subjected to oxygen-glucose deprivation and reperfusion to simulate ischemic conditions. The findings demonstrate that RV02 attenuates neuronal mitochondrial damage and scavenges reactive oxygen species (ROS) through mitophagy activation. Furthermore, Parkin knockdown was found to abolish RV02's ability to activate mitophagy and neuroprotection in vitro. These results suggest that RV02 shows promise as a neuroprotective agent, with the activation of Parkin-mediated mitophagy potentially serving as the primary mechanism underlying its neuroprotective effects.
Animals
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Ubiquitin-Protein Ligases/genetics*
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Mitophagy/drug effects*
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Resveratrol/analogs & derivatives*
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Neuroprotective Agents/pharmacology*
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Humans
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Neurons/metabolism*
;
Reactive Oxygen Species/metabolism*
;
Ischemic Stroke/genetics*
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Male
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Quinolines/pharmacology*
;
Mice
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Fallopia japonica/chemistry*
;
Mitochondria/metabolism*
;
Reperfusion Injury/metabolism*
;
Rats
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Mice, Inbred C57BL
;
Disease Models, Animal
5.Impact of Minimally Invasive Extracorporeal Circulation on Systemic Inflammatory Response and Transfusion Requirements after Coronary Artery Bypass Grafting
Xiaojuan ZHOU ; Libin YANG ; Peng YANG ; Hao GONG ; Xu YANG
Journal of Kunming Medical University 2025;46(3):58-65
Objective This study aims to explore the effects of Minimally Invasive Extracorporeal Circulation(MECC)on systemic inflammatory response and transfusion requirements following Coronary Artery Bypass Grafting(CABG).Methods A total of 126 patients who underwent CABG from January 2023 to January 2024 were selected and randomly divided into an observation group and a control group,with 63 patients in each group.The observation group received MECC,while the control group was treated with Conventional Extracorporeal Circulation(CECC).Inflammatory response indicators,immune system function,coagulation function,renal function,cardiac function,and clinical symptoms were monitored preoperatively and at 24,48,and 72 hours postoperatively for comparison and analysis.Results At 24 hours postoperatively,CRP,IL-6 and TNF-α levels in the observation group were(18.5±3.7)mg/L,(15.2±3.4)pg/mL and(25.3±5.6)pg/mL,respectively,which were significantly lower than those in the control group(P<0.05).At 48 hours postoperatively,the CD4+/CD8+ratio in the observation group was 1.6±0.3,which was higher than that in the control group(P<0.05).At 72 hours postoperatively,the PT and APTT in the observation group were(12.1±1.2)seconds and(30.4±3.2)seconds,respectively,which were significantly lower than those in the control group(P<0.05).Additionally,72 hours after surgery,SCr and BUN in the observation group were(1.1±0.2)mg/dL and 14.6±3.1 mg/dL,respectively,which were significantly lower than those in the control group(P<0.05).In terms of cardiac function indexes,at 24 hours postoperatively,CI,LVEF,cTnⅠ and BNP in the observation group were(2.6±0.5)L/min/m2,(55.6±4.0)%,(0.14±0.03)ng/mL,and(280±30)pg/mL,respectively,which were significantly better than those in the control group(P<0.05).At all postoperative time points,the VAS score,complication rate,length of hospital stay and ICU stay were significantly better in the observation group than in the control group(P<0.05),with the VAS score at 24 hours postoperatively being(4.8±1.2)compared to(5.5±1.3)in the control group(P<0.05).Conclusions MECC demonstrates significant advantages in attenuating systemic inflammatory response after CABG,protecting multi-system function,reducing postoperative blood transfusion requirements,and improving postoperative recovery.Compared with traditional extracorporeal circulation,MECC effectively reduce postoperative inflammatory reactions and complications,enhancing the quality of life for patients post-surgery,and shows broad clinical application prospects.
6.Clinical characteristics and survival analysis of nasopharyngeal carcinoma combined with multiple primary malignancies
Libin ZHANG ; Xiufang QIU ; Shuyuan MAO ; Ting XU ; Honghong ZHANG ; Xinyi HONG ; Ting LIN ; Zihan CHEN ; Jing WANG ; Zijie WU ; Youliang WENG ; Sufang QIU
Chinese Journal of Radiation Oncology 2025;34(12):1183-1190
Objective:To investigate the clinical characteristics and survival outcomes of patients with nasopharyngeal carcinoma (NPC) complicated by multiple primary malignancies (MPCs) in a real-world setting.Methods:A retrospective study was performed on 238 NPC patients with MPCs who received radical radiotherapy at Fujian Cancer Hospital between January 1st, 2004 and December 31st, 2023. The primary endpoints were overall survival (OS) and cumulative survival rate. Survival analysis was conducted using the Kaplan-Meier method with log-rank / Breslow tests, and univariate analysis of prognostic factors was performed using the Cox proportional hazards model.Results:A total of 246 primary malignant tumors were identified in 238 patients, involving 12 organ systems and 39 tumor types. The most common coexisting malignancies occurred in the respiratory and intrathoracic organs [25.2% (62/246)], followed by digestive organ malignancies [22.8% (56/246)], malignancies of the lip, oral cavity, and pharynx [22.8% (56/246)], and thyroid and other endocrine gland malignancies [15.4% (38/246)]. The median OS was 186 months, and the 3-, 5-, and 10-year cumulative survival rates were 90.84%, 85.25%, and 69.45%, respectively. Poorer survival was associated with male sex, age>48 years at onset, locally advanced disease (stage IVA), synchronous MPCs and/or digestive system malignancies, fewer total cycles of chemotherapy, and lack of concurrent or adjuvant chemotherapy.Conclusions:In patients with NPC, MPCs most frequently involve the respiratory system, digestive system, and head and neck organs (including the thyroid). Male sex, older age, locally advanced primary NPC, synchronous and/or digestive system MPCs, fewer chemotherapy cycles, and lach of concurrent or adjuvant chemotherapy were significantly associated with poorer prognosis.
7.Effects of phloretin on the proliferation,apoptosis,and tumorigenicity of ovarian cancer cells by regulating Rac1/Akt/NF-κB signaling pathway
Yuehong TANG ; Yuning LUO ; Libin XU ; Xiaoying HU ; Chunping QIU
Journal of China Medical University 2025;54(9):821-825,831
Objective To explore the effect of phloretin on the proliferation,apoptosis,and tumorigenicity of ovarian cancer cells by regu-lating the Rac1/Akt/NF-κB signaling pathway.Methods The ovarian cancer cell line SKOV3 and the human normal ovarian epithelial cell line IOSE-80 were divided into the following groups:control,low-dose phloretin,medium-dose phloretin,high-dose phloretin,PM A,and high-dose phloretin+PMA.Morphological changes were observed under a microscope.Cell viability and apoptosis were assessed using the CCK-8 assay,colony formation assay,and flow cytometry.Western blotting was performed to detect the expression of proteins related to the Rac1/Akt/NF-κB signaling pathway.Tumor-bearing nude mice were established,tumor weights were measured,and the expres-sion levels of Rae1 and Akt in tumor tissues were analyzed.Results Compared with the control group,SKOV3 cells treated with low-,medium-,and high-dose phloretin showed reduced survival rate,colony formation,and expression of p-NF-κB p65/NF-κB p65,p-Akt/Akt,and Rac 1 in a dose-dependent manner.However,PM A reversed the inhibitory effects of high-dose phloretin on the malignant progression of ovarian cancer.In vivo experiments demonstrated that phloretin significantly inhibited tumor growth and reduced Akt and Rae1 expres-sion in tumor tissues(P<0.05).Conclusion Phloretin suppresses the malignant progression of ovarian cancer by inhibiting the Rae1/Akt/NF-κB signaling pathway.
8.Effects of phloretin on the proliferation,apoptosis,and tumorigenicity of ovarian cancer cells by regulating Rac1/Akt/NF-κB signaling pathway
Yuehong TANG ; Yuning LUO ; Libin XU ; Xiaoying HU ; Chunping QIU
Journal of China Medical University 2025;54(9):821-825,831
Objective To explore the effect of phloretin on the proliferation,apoptosis,and tumorigenicity of ovarian cancer cells by regu-lating the Rac1/Akt/NF-κB signaling pathway.Methods The ovarian cancer cell line SKOV3 and the human normal ovarian epithelial cell line IOSE-80 were divided into the following groups:control,low-dose phloretin,medium-dose phloretin,high-dose phloretin,PM A,and high-dose phloretin+PMA.Morphological changes were observed under a microscope.Cell viability and apoptosis were assessed using the CCK-8 assay,colony formation assay,and flow cytometry.Western blotting was performed to detect the expression of proteins related to the Rac1/Akt/NF-κB signaling pathway.Tumor-bearing nude mice were established,tumor weights were measured,and the expres-sion levels of Rae1 and Akt in tumor tissues were analyzed.Results Compared with the control group,SKOV3 cells treated with low-,medium-,and high-dose phloretin showed reduced survival rate,colony formation,and expression of p-NF-κB p65/NF-κB p65,p-Akt/Akt,and Rac 1 in a dose-dependent manner.However,PM A reversed the inhibitory effects of high-dose phloretin on the malignant progression of ovarian cancer.In vivo experiments demonstrated that phloretin significantly inhibited tumor growth and reduced Akt and Rae1 expres-sion in tumor tissues(P<0.05).Conclusion Phloretin suppresses the malignant progression of ovarian cancer by inhibiting the Rae1/Akt/NF-κB signaling pathway.
9.Clinical characteristics and survival analysis of nasopharyngeal carcinoma combined with multiple primary malignancies
Libin ZHANG ; Xiufang QIU ; Shuyuan MAO ; Ting XU ; Honghong ZHANG ; Xinyi HONG ; Ting LIN ; Zihan CHEN ; Jing WANG ; Zijie WU ; Youliang WENG ; Sufang QIU
Chinese Journal of Radiation Oncology 2025;34(12):1183-1190
Objective:To investigate the clinical characteristics and survival outcomes of patients with nasopharyngeal carcinoma (NPC) complicated by multiple primary malignancies (MPCs) in a real-world setting.Methods:A retrospective study was performed on 238 NPC patients with MPCs who received radical radiotherapy at Fujian Cancer Hospital between January 1st, 2004 and December 31st, 2023. The primary endpoints were overall survival (OS) and cumulative survival rate. Survival analysis was conducted using the Kaplan-Meier method with log-rank / Breslow tests, and univariate analysis of prognostic factors was performed using the Cox proportional hazards model.Results:A total of 246 primary malignant tumors were identified in 238 patients, involving 12 organ systems and 39 tumor types. The most common coexisting malignancies occurred in the respiratory and intrathoracic organs [25.2% (62/246)], followed by digestive organ malignancies [22.8% (56/246)], malignancies of the lip, oral cavity, and pharynx [22.8% (56/246)], and thyroid and other endocrine gland malignancies [15.4% (38/246)]. The median OS was 186 months, and the 3-, 5-, and 10-year cumulative survival rates were 90.84%, 85.25%, and 69.45%, respectively. Poorer survival was associated with male sex, age>48 years at onset, locally advanced disease (stage IVA), synchronous MPCs and/or digestive system malignancies, fewer total cycles of chemotherapy, and lack of concurrent or adjuvant chemotherapy.Conclusions:In patients with NPC, MPCs most frequently involve the respiratory system, digestive system, and head and neck organs (including the thyroid). Male sex, older age, locally advanced primary NPC, synchronous and/or digestive system MPCs, fewer chemotherapy cycles, and lach of concurrent or adjuvant chemotherapy were significantly associated with poorer prognosis.
10.UNOS based study for long-term outcomes and risk factors of liver transplantation recipients receiving grafts from donor aged 80 years and over
Libin DONG ; Xiaobo WANG ; Shuqi CAI ; Kai WANG ; Xiao XU
Chinese Journal of Organ Transplantation 2024;45(6):382-390
Objective:To investigate the long-term prognosis of liver transplantation (LT) recipients who received grafts from donors aged ≥80 years and the associated risk factors.Methods:Clinical and follow-up data of LT recipients from January 2002 to June 2023 were retrospectively analyzed using the United Network for Organ Sharing (UNOS) database. Donors were categorized into three groups : non-elderly donors (NED, age < 60 years), elderly donors (ED, age 60-79 years), and very elderly donors (VED, age ≥80 years). Propensity score matching (PSM) was used to reduce baseline selection bias among the groups. Survival rates were calculated using the Kaplan-Meier method, and differences among the groups were compared using the Log-Rank test. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent risk factors for overall survival (OS) in the VED group. Recipients were further subdivided into three age groups (<50 years, 50-69 years, and ≥70 years) to compare survival outcomes among NED, ED, and VED groups.Results:A total of 115, 089 LT recipients were included, comprising 95, 973 (83.4%) in the NED group, 18, 520 (16.1 %) in the ED group, and 596 (0.5 %) in the VED group. After 3∶3∶1 PSM, each group included 1, 623 recipients for NED and ED, and 541 for VED, with no significant differences in baseline data. The 10-year OS rates for NED, ED, and VED groups were 61.8%, 55.9%, and 47.8%, respectively, and the 10-year graft survival (GS) rates were 61.3 %, 53.8%, and 45.9 %, respectively, with all comparisons showing statistical significance ( P< 0.001). In recipients aged <70 years, the VED group had significantly lower OS and GS rates (49.0% and 47.1 %, respectively ) compared to the NED (63.7 % and 61.8%) and ED (57.7% and 55.2 %) groups ( P< 0.001 ). For recipients aged ≥70 years, there were no significant differences in 10-year OS and GS among the NED (47.2% and 48.7 %), ED (47.0 % and 48.7 %), and VED (40.0 % and 39.2 %) groups ( P= 0.992 and P= 0.996, respectively). Cox regression analysis identified cold ischemia time ≥8 hours ( HR=1.447, 95% CI: 1.088-1.923, P=0.011), pre-transplant ICU dependence ( HR=1.803, 95% CI: 1.176–2.765, P=0.007), and hepatitis B/C virus infection ( HR =1.432, 95% CI: 1.057-1.941, P=0.020) as independent risk factors for OS in the VED group. Conclusions:Liver grafts from VED grafts significantly reduce long-term OS and GS in recipients, except in those aged ≥70 years where prognosis is comparable to recipients of NED and ED grafts.. For the VED group, factors such as cold ischemia time ≥8 hours, pre-transplant ICU dependence, and hepatitis B/C virus infection markedly influence the prognosis.

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